Your next question in your risk assessment of Jessie is:

What are Jessie's daily eating patterns?

Betsy tells you that Jessie eats many snacks. She gets cookies after breakfast and mid-morning, along with a bottle of juice. In the afternoon, after she wakes up from her nap, she'll get cookies or brownies. She also rewards Jessie for good behavior with candy.

Your response to Betsy could be:

Frequent snacking on sweet, sticky or starchy foods that contain fermentable carbohydrates can contribute to dental decay. Frequent ingestion of sucrose can increase the percentage of S. mutans in dental plaque which, as you know, is the microorganism most frequently implicated in dental caries.Good snacking choices will benefit Jessie's oral health and total health and will contribute to establishing better eating habits. Substitute less cariogenic foods, like fruits and vegetables, as snacks.

Snacking is a serious risk factor. Drinking any beverage with sugar in it is a problem. Some foods appear to be healthy, but are likely to cause problems - advise Betsy to read the labels of any drinks or foods she gives to Jessie to determine if sugar in any form is present. The longer the food or drink is in the mouth, the greater and faster the damage. Sipping a drink or sucking candy over a long period of time leads to disasters. Providing the parent or caregiver with choices in how to reduce this risk is a good idea.

Monitor her diet for the amount and frequency of fermentable carbohydrates and restrict the intake of these sweets to mealtimes when her baby's salivary flow is greater. The saliva has numerous functions including buffering and neutralizing the acid produced by plaque bacteria and also remineralizing the tooth by providing minerals that can replace those dissolved from the tooth during demineralization. Saliva also facilitates the clearance of food from the oral cavity.